propylthiouracil and Purpura

Topics: Adult; Antithyroid Agents; Cheek; Female; Graves Disease; Humans; Propylthiouracil; Purpura; Vasculitis

Propylthiouracil (PTU) is a synthetic antithyroid drug that can induce ANCA-associated vasculitis.. A 27-year-old woman diagnosed with Graves' disease was on PTU for the past 10 years. She developed purpuric lesions of the legs and on the tip of the nose diagnosed as vasculitis. ANCAs were positive, with anti-MPO and anti-PR3 on blood ELISA. After discontinuation of PTU, she was able to fully recover.. All synthetic antithyroid drugs can induce ANCA-associated vasculitis, more often PTU. In most cases, antibodies are directed against MPO. Dual anti-MPO and anti-PR3 positivity is possible, but rare. The mechanism could be through an accumulation of PTU in neutrophils, altering the structure of MPO and making it immunogenic. PTU can also induce ANCA-free or lupus vasculitis, maculopapular rashes or urticaria. Many other drugs can induce ANCA-associated vasculitis.

Topics: Adult; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis; Antibodies, Antineutrophil Cytoplasmic; Antithyroid Agents; Female; Humans; Hyperthyroidism; Propylthiouracil; Purpura

Topics: Aged; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis; Antibodies, Antineutrophil Cytoplasmic; Antithyroid Agents; Ear, External; Female; Humans; Hyperthyroidism; Prednisone; Propylthiouracil; Purpura; Vasculitis, Leukocytoclastic, Cutaneous

Topics: Antithyroid Agents; Child, Preschool; Female; Humans; Lung Diseases; Propylthiouracil; Pulmonary Alveoli; Purpura; Vasculitis

A 36-year-old woman presented at our clinic with symmetrical, tender, palpable purpuric lesions on her lower legs and buttocks after restarting PTU therapy for relapsing Graves' disease. PTU-induced vasculitis was diagnosed with remarkable ANCA anti-MPO and anti-PR3 antibody positivity. The purpuric skin lesions resolved immediately after discontinuation of the drug and the ANCA titres lowered. In the presence of activated neutrophils, PTU could induce a high cytotoxity and injure the vessel walls. Treatment of choice is discontinuation of the drug. Sometimes more aggressive therapy as cyclophosphamide or plasmapheresis is warranted.

Topics: Adult; Antibodies, Antineutrophil Cytoplasmic; Biopsy; Female; Graves Disease; Humans; Myeloblastin; Propylthiouracil; Purpura; Serine Endopeptidases; Vasculitis, Leukocytoclastic, Cutaneous

Topics: Adult; Female; Fever; Humans; Immune Complex Diseases; Leg Ulcer; Lung Diseases; Propylthiouracil; Purpura; Skin Transplantation; Transplantation, Autologous; Vasculitis

Chronic idiopathic thrombocytopenic purpura (ITP) and hyperthyroidism coexisted in two children. In one, hyperthyroidism developed nine years after the onset of purpura. In the other, the two diseases appeared concomitantly. It is important to distinguish the thrombocytopenia due to ITP from that due to antithyroid drugs.

Topics: Azathioprine; Child; Female; Graves Disease; Humans; Prednisone; Propylthiouracil; Purpura; Purpura, Thrombocytopenic; Splenectomy; Thrombocytopenia

Topics: Adult; Drug Hypersensitivity; Female; Humans; Propylthiouracil; Purpura

Topics: Adolescent; Antibodies, Antinuclear; Biopsy; Disseminated Intravascular Coagulation; Female; Heparin; Humans; Hyperthyroidism; Kidney Glomerulus; Prednisone; Propylthiouracil; Purpura; Skin

Topics: Animals; Gastropoda; Humans; Propylthiouracil; Purpura; Purpura, Thrombocytopenic; Thiouracil